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RET SUNRISE PHYSICAL THERAPY, PLLC

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Company Details

Legal Name: RET SUNRISE PHYSICAL THERAPY, PLLC
Jurisdiction: WASHINGTON
Entity Type: WA PROFESSIONAL LIMITED LIABILITY COMPANY
Category: DOMESTIC ENTITY
Status: Active
Formation/ Registration Date: June 10th 2013
Expiration date: 30 Jun 2026
UBI Number: 603 308 872
ZIP code: 98005
City: Bellevue
County: KING
Home State: KENTUCKY
Principal Office Street Address: Google Maps Logo 11711 NE 12TH ST #3A, BELLEVUE, KY, 98005, UNITED STATES
Principal Office Mailing Address: Google Maps Logo 1650 LYNDON FARM CT STE 300, LOUISVILLE, KY, 40223-5005, UNITED STATES
Supporting healthcare providers fighting with COVID-19: $10,008

Contact Details

E-Mail: LEGAL@GOCONFLUENT.COM
Phone Number: +1 502-422-7697

Nature of Business

Health Care, Social Assistance & Service Organization, PHYSICAL THERAPY

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Registered Agent Information

Name Role
CORPORATION SERVICE COMPANY Registered Agent

Key Officers & Management

Name Role
RET PHYSICAL THERAPY LLC Governing Person

National Provider Identifier

NPI Number:
1942641147
Certification Date:
2022-12-27

Authorized Person:

Name:
DWAN DIAZ
Role:
CREDENTIALING COORDINATOR
Phone:

Taxonomy:

Selected Taxonomy:
225XH1200X - Hand Occupational Therapist
Is Primary:
No
Selected Taxonomy:
332B00000X - Durable Medical Equipment & Medical Supplies
Is Primary:
No
Selected Taxonomy:
332BC3200X - Customized Equipment (DME)
Is Primary:
No
Selected Taxonomy:
225100000X - Physical Therapist
Is Primary:
Yes

Contacts:

Fax:
4254520704
Fax:
2532564809

History

Type Old value New value Date of change
Name change RET SUNRISE PHYSICAL THERAPY LLC RET SUNRISE PHYSICAL THERAPY, PLLC 2018-09-28
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